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NPI Code Detail

MEDICARE: TARA JERNIGAN

MEDICARE:   TARA  JERNIGAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1245199868
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA JERNIGAN
Provider Business Mailing Address
First Line : 1304 SARATOGA AVE NE APT 3
Second Line :
City : WASHINGTON
State : DC
Zip : 20018-1963
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1304 SARATOGA AVE NE APT 3
Second Line :
City : WASHINGTON
State : DC
Zip : 20018-1963
Country : US
Telephone Number : 202-590-1652
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2026
Last Update Date : 01/20/2026

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Directions to “ TARA JERNIGAN ” Practice Location

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